The American journal of medicine
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The 2023 American Heart Association (AHA)/American College of Cardiology (ACC) Multisociety Guideline for the Management of Patients with Chronic Coronary Disease presents important updates to the care of patients with chronic coronary disease. The recommendations of these guidelines inform the care for patients with 1) asymptomatic coronary artery disease, 2) stable angina or equivalent symptoms (e.g., dyspnea upon exertion), 3) symptomatic nonobstructive coronary disease including coronary microvascular dysfunction and vasospasm, and 4) left ventricular (LV) systolic dysfunction with known coronary artery disease. In this review, we aim to demonstrate key recommendations in the 2023 guideline using the following four hypothetical cases.
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Smoking elevates blood pressure (BP) whereas smoking cessation increases body weight (BW), which predisposes new quitters to the development of hypertension. This study aimed to investigate the effect of smoking cessation and subsequent BW change on the odds of developing hypertension. ⋯ The odds of developing hypertension were increased in new quitters only when their BW gain was not controlled after smoking cessation.
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We aimed to investigate the association of electrocardiogram (ECG) findings with outcomes in patients with chronic coronary syndrome. ⋯ In patients with chronic coronary syndrome, an abnormal ECG tracing was associated with an increased risk of cardiovascular death. Our findings underscore the importance of the ECG in cardiovascular risk stratification and prognostication.
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Real-world mortality data regarding heart failure in patients with comorbid chronic kidney disease remains limited, especially following the advent of advanced heart failure therapies. ⋯ Our study showed a significant increase in heart failure AAMR in patients with comorbid chronic kidney disease in recent eras. Further effort is needed to optimize cardioprotective agents for this population and to address demographic discrepancies at the policy level.